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SHELLY ELYSE EISENSTADT LCSW
NPI 1407551385
Social Worker - Clinical in Marietta, GA

Active since March 31, 2023Opted out of Medicare · through May 8, 2028
4415 KINGS WAY NE, MARIETTA, GA 30067(404) 518-5325 Get Directions Write a Review

NPPES record last updated: March 31, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Shelly Elyse Eisenstadt Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHELLY ELYSE EISENSTADT LCSW (NPI 1407551385) is an individual clinical provider in Marietta, Georgia, licensed in Georgia (CSW004993) and active in the NPI registry since March 2023. She has opted out of Medicare through May 8, 2028.

NPPES Registry Identity

NPI1407551385
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameSHELLY ELYSE EISENSTADTCredential: LCSW
Location Address4415 KINGS WAY NEMarietta, GA 30067-3633
Mailing Address4415 Kings Way NeMarietta, GA 30067-3633 · (404) 518-5325
Phone(404) 518-5325
Sole ProprietorYes
Enumeration DateMarch 31, 2023
NPPES CertifiedMarch 31, 2023
✔ NPI 1407551385 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in GA · CSW004993
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
4415 KINGS WAY NE, Marietta, GA 30067
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Shelly Elyse Eisenstadt Lcsw has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from May 8, 2024 through May 8, 2028.

Opt-Out Effective DateMay 8, 2024
Opt-Out In Effect ThroughMay 8, 2028Opt-out affidavits renew automatically every two years unless cancelled

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shelly Eisenstadt's NPI number?

The NPI number for Shelly Eisenstadt is 1407551385. It was assigned to this individual provider in the NPPES registry on March 31, 2023.

Where is Shelly Eisenstadt located?

Shelly Eisenstadt practices at 4415 Kings Way NE, Marietta, GA 30067. The listed phone number is (404) 518-5325.

What is Shelly Eisenstadt's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Shelly Eisenstadt enrolled in Medicare?

No. Shelly Eisenstadt has opted out of Medicare through May 8, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Shelly Eisenstadt was last updated on March 31, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.